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Written by: Zhang Meilan, Zhu Haiqi, Li Enci, Zheng Cuibi
2021-07-12 12:00
Last update date: 2021-07-12 12:00
Doctor Wu International, who once left the scene during the liver replacement operation and left the patient to wait three hours for nothing after the "open belly", is now a professor at the Chinese University School of Medicine and the head of the Department of Hepatobiliary and Pancreatic Surgery at the Prince of Wales Hospital.
"Hong Kong 01" learned that in June, Wu International approved a female doctor who was undergoing the first year of specialist training to be responsible for difficult bile duct and ileal connections when dealing with a "pancreaticoduodenectomy" for a tumor patient.
The Weiyuan Hospital confirmed the incident and will set up a task force to review it to ensure that the difficulty of the operation performed by the trained doctors is commensurate with their level. The School of Medicine of CUHK stated that it will deal with it strictly and fully cooperate with the Hospital Authority to follow up.
According to the Hong Kong College of Surgeons, pancreaticoduodenectomy is usually only performed by doctors who have obtained academician qualifications, that is, they have to receive at least six years of surgical training and pass examinations.
Many authorities in hepatobiliary and pancreatic surgery have claimed that connecting the bile duct to the intestine is a very difficult operation. The famous doctor Lu Chongmao said more bluntly that it is unprecedented to allow a fledgling doctor to take charge of this procedure. Take responsibility.
Extended reading: New prospective doctor Wu International requires 13 years of 800 operations to practice surgery for difficult operations to obtain surgical specialties
A reporter from "Hong Kong 01" earlier asked Wu International to approve a female doctor who was receiving the first year of specialized training to perform complex surgery, but he did not respond immediately.
(Photo by Cen Zhuoxi)
Wu International was not renewed by the Faculty of Medicine of the University of Hong Kong in 2017 after he left during the operation. In 2019, he was hired by the Faculty of Medicine of CUHK as Professor of Hepatobiliary and Pancreatic Surgery. He is currently the leading hospital of the New Territories East Network, Prince of Wales Hospital. Supervisor of surgery.
The source revealed to "Hong Kong 01" that the Weiyuan Hepatobiliary and Pancreatic Surgery team performed surgery on a patient with tumor last month. Wu International approved a female doctor surnamed Yu who received specialized training for the first year to connect the bile duct and ileum to the patient.
In 2017, Wu Guoji left the scene in the middle of a liver replacement operation, causing the patient to wait three hours in vain after having his belly open.
(Profile picture / Photo by Luo Junhao)
Weiyuan reviews the surgical training arrangements to ensure that the difficulty of the operation is commensurate with the professional level of the trained doctors
Weiyuan confirmed that a pancreaticoduodenectomy (Whipple operation) was performed on a patient on June 9 this year. A doctor who received the first year of surgical training performed the bile duct-ileum anastomosis procedure for the patient under the supervision of the head of hepatobiliary and pancreatic surgery. There was leakage in the sutures of other wounds after the operation, and he was discharged from the hospital one month later. There was a consultant doctor and an associate consultant doctor at the operation.
Weiyuan Hospital will set up a task force to review the surgical training arrangements for hepatobiliary and pancreatic surgeons, including the types of operations that can be performed by trained doctors of different qualifications under the supervision, to ensure that the difficulty of the operations performed by the trained doctors is commensurate with their professional level.
The Faculty of Medicine of CUHK stated that when any suspicion is discovered, it will fully cooperate with the follow-up work of the HA and deal with it strictly. No complaints have been received so far.
Many hepatobiliary and pancreatic surgery authorities have stated that connecting the bile duct to the intestine is an extremely difficult operation.
The picture shows the intestinal model.
(Information Picture/Photographed by Zhang Haowei)
School of Surgery: usually by a specialist who has completed at least 6 years of training
"Hong Kong 01" asked the School of Surgeons in charge of training surgeons whether the biliary ileal anastomosis procedure is suitable for the first-year trained doctors. The hospital replied that pancreaticoduodenectomy is usually only performed by doctors who have obtained the academician qualifications of the academy. responsible for.
In other words, they are doctors who have completed at least six years of training and passed the exam.
Regarding the question of whether complaints have been received, the hospital said that the public generally consults the relevant hospital or the Hong Kong Medical Council about such incidents. The relevant institutions will, depending on the nature of the incident, seek the opinions of the hospital when necessary.
The Prince of Wales Hospital will set up a task force to review the surgical training arrangements for hepatobiliary and pancreatic surgeons.
(Profile picture)
The involved Dr. Yu graduated from the School of Medicine of CUHK in 2019 and began his surgical training last year.
It is understood that she will be transferred to the accident and emergency departments of other hospitals on the same network this month to continue to receive specialized training.
The reporter of "Hong Kong 01" earlier asked Wu International about the criteria for authorizing Dr. Yu to perform the operation, but he did not respond.
Dr. Yu also did not respond to reporters' enquiries about the incident.
Lu Chongmao said that he would not arrange for a doctor trained in the first year to perform bile duct ileal anastomosis.
(Information Picture/Photographed by Lu Yiming)
Lu Chongmao: The first year training doctors will not do bile duct anastomosis surgery
"Hong Kong 01" asked four hepatobiliary and pancreatic surgery experts for general training guidelines without mentioning the identities of Dr. Wu Guoji and Yu.
Lu Chongmao, dean of the Hong Kong University Shenzhen Hospital and director of the Liver Transplant Center at Queen Mary Hospital, said, "Generally, doctors trained in the first year really do not perform the operation of bile duct anastomosis. Few doctors trained in the first year have this ability." "I haven't seen it in my own experience, and I will not do this." He believes that if a patient has any accidents, the senior doctors present should take full responsibility.
On June 9, Wu International approved a female doctor surnamed Yu who received specialized training for the first year to connect the bile duct and ileum to the patient.
(Photo by Cen Zhuoxi)
Lu Chongmao explained that when removing the cancerous tissue in the patient, part of the bile duct may be removed at the same time. The doctor will connect one end of the bile duct incision to the intestine. The relevant procedure is an extremely difficult operation. It is the most difficult operation in Hong Kong and the Mainland. "If the mouthpiece is not completely impermeable, the leakage of fluid (bile) will cause inflammation, bacterial infection, severe abscesses, and may cause secondary complications later, sometimes causing bleeding in nearby blood vessels." Experienced doctors are responsible. Even if trained doctors are required to learn, they must be doctors who have at least a few years of experience and are close to the specialist qualifications, under the supervision of their supervisors.
Xia Wei said that the bile duct-ileum anastomosis procedure should be handled by an experienced doctor.
(Photo/Photo by Ou Jiale)
Professor Xia Wei of the University of Hong Kong: Not everybody knows how to sew with a needle and thread
Xia Wei, Honorary Clinical Associate Professor of Hepatobiliary and Pancreatic Surgery at the University of Hong Kong School of Medicine, also said that in order to completely remove cancer cells from the patient's body, the doctor will remove the nearby common bile duct, and then connect the bile duct to the intestine to draw the bile away.
He believes that the connection is complicated. "Not everyone knows how to sew when he lifts the needle and thread." Once there is bile leakage from the mouth, the patient may have complications. The relevant procedures should be handled by an experienced doctor. "The only way to get a specialist qualification is to do it. The beginning of a large and complex operation."
The Faculty of Medicine of CUHK stated that when any suspicion is discovered, it will fully cooperate with the follow-up work of the Hospital Authority and deal with it strictly.
(Profile picture)
Senior hepatobiliary and pancreatic experts: After several years of training, doctors can only be responsible under the supervision of their supervisor
Another senior hepatobiliary and pancreatic expert who did not want to be named stated that the bile duct is only 4 to 6 mm wide. Even if the bile duct is dilated, it is only 1 cm wide, which is still more narrow than the 4 cm wide small intestine and the 8 cm wide large intestine. It is difficult to reconcile, "If the gestures are not good, the mouth will leak, bile will accumulate in the body, and it will be prone to inflammation or infection." Therefore, doctors who have been trained for at least a few years can only be responsible under the supervision of an experienced instructor.
A surgeon from Queen Mary Hospital stated that there is no explicit stipulation that doctors who are trained in the first year cannot be responsible for the operation. It depends on the judgment of the surgeon, but he agrees that the situation is relatively rare, and that doctors who have just started training generally only do simple things. Anastomosis procedure, or assist in opening the patient’s intestines so that the abdominal cavity is clearly visible.
When Deng Guisi, a patient seeking liver, received a liver transplant, Wu International (left) performed an operation on her.
(Profile picture)
Wu International graduated from the Faculty of Medicine of the University of Hong Kong in 1995 and worked in the teaching hospital of the University of Hong Kong-Queen Mary Hospital. In 2002, he was admitted to the Specialty of Surgery qualification, and he switched to the private market in 2010.
He joined the liver replacement team of the University of Hong Kong as an associate professor in August 2016.
On October 13, 2017, Wu International was on duty at the Queen Mary Hospital. The day before, he was known to have to supervise the operation of liver replacement on that day. However, he told the surgeon that he was going to the Sanatorium and Hospital for the operation. As a result, the surgeon was waiting for Wu International After returning to Mary for the operation, the patient "opened his belly" and waited for three hours.
He was not renewed by the Faculty of Medicine of the University of Hong Kong, and transferred to the Shenzhen Hospital of the University of Hong Kong. In 2019, he returned to Hong Kong to join the Faculty of Medicine of the University of Hong Kong.
The School of Surgeons under the Academy of Medical Sciences stated that pancreaticoduodenectomy is usually only performed by doctors who have obtained the qualifications of academicians of the Academy.
(Data Picture/Photographed by Lin Ruoqin)
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